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- Dahlman, Disa, et al.
(författare)
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Health Literacy among Swedish Patients in Opioid Substitution Treatment : A Mixed-Methods Study
- 2020
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Ingår i: Drug and Alcohol Dependence. - : Elsevier BV. - 0376-8716. ; 214
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Tidskriftsartikel (refereegranskat)abstract
- Background: Poor health and unmet healthcare needs is common among people with substance use disorder (SUD) including patients in opioid substitution treatment (OST). Low health literacy (HL) is associated with poverty, low education and physical limitations, but is unexplored in an OST context. Methods: Mixed-methods were used. Participants were consecutively recruited by clinic staff or researcher, from five OST clinics in Malmö, Sweden, during September – November 2019. HL level was measured through HLS-EU-Q16 (n?=?286). Self-reported socioeconomic correlates of HL were analyzed through logistic regression. Patients’ experiences of HL-related problems were assessed through six focus group interviews (n?=?23) moderated by an OST employee. Results: While 46% had sufficient HL (13–16 points of maximum 16), 32% did not receive a HL score due to too many missing answers. No correlates of sufficient HL level were found. Missing HL level was associated with low educational attainment (Ajusted odds ratio [AOR] 1.94; 95% Confidence interval [CI] 1.13–3.32) and negatively associated with employment (AOR 0.28; 95% CI 0.11–0.71). Qualitative data revealed a diversity in participants’ self-assessed capabilities, and problems associated with access, comprehension, trust and dependency on addiction-specific services. Conclusions: This study highlights that HL level is low, and identifies a number of concrete problems related to HL in the studied population. The results implicate a need for tailored interventions regarding health information among OST patients.
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| 2. |
- Englund, Viktor, 1983-
(författare)
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Fångsamhället som inte skulle finnas : Överlevnad och anpassning i fängelse under åren 1890–1920
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This dissertation studies how prisoners could affect and influence their life in two different prison systems and what it meant for how the systems worked in practice. The systems in question are the Philadelphia system (the separate system) and the Auburn system (the congregate system). To a large extent, these are studied from the example of the central prison at Långholmen, which used both systems. Other Swedish prisons also form a part of the study, mainly through prison biographies. The research period is 1890–1920. This was when the separation system peaked in Sweden with the longest isolation penalties.The main question of the thesis is: in what ways did prisoners try to manage and influence their life in prison, how did those actions affect their everyday situation in prison, and how does the importance of those effects appear for the prisoner?In earlier research we can, to some extent, observe a hidden world behind the prison walls where it is obvious that things differed significantly from how they were supposed to work. In order to reach this hidden world, a prisoner-centered perspective has been used, which in this book means a systematic focus on the prisoners' actions and experiences. The result of this approach can be summed up in what I call a prison community that should not have existed. To a large extent, it is this community that we see in the prisoners' actions documented in interrogation protocols and described in prisoners’ biographies.The most important result of this dissertation is that there was a prison community even among isolated prisoners. This is important because the separate system was built upon the idea of isolation, it was the very foundation of the model, and it was a system widely spread internationally. The prisoners' forbidden acts produced a community that was not meant to exist. The dissertation has also studied other ways for prisoners to affect their situation, for example: simulations of ill health, self-harm actions, stimulation strategies, smuggling and illegal production, bribes and thefts.
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| 3. |
- Garpenhag, Lars, 1981-
(författare)
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Anna Lundberg, Läkarnas blanka vapen
- 2010
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Ingår i: Historisk Tidskrift. - 0345-469X .- 2002-4827. ; 130:4, s. 811-812
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Recension (övrigt vetenskapligt/konstnärligt)
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| 8. |
- Garpenhag, Lars, 1981-
(författare)
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Kriminaldårar : Sinnessjuka brottslingar och straffrihet i Sverige, ca 1850–1930
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis is to explain how the management of insane offenders operated and changed in Sweden in the approximate period 1850–1930. The investigation concerns primarily a level of practice, i.e. how insane offenders were treated in courts and insane asylums as a part of the everyday activities of these institutions. Their treatment depended on a double set of social categorizations. In the courts the insane had to be discerned from the sane, and at asylums criminals were distinguished from non-criminal patients. Asylum patient records and other sources are used to examine different aspects of the the trial and post-trial treatment of insane offenders, as well as their social composition as a group.It is shown that during the period of study, the management of criminal cases of this kind went through important changes. One important change was that the boundaries of criminal responsibility shifted when new kinds of deviant mental conditions came to be taken into consideration as grounds for exemption from punishment. An important observation is that the division of labor in trials, between lawyers and physicians, as well as between medical professionals, was a harmonious one. No conflicts of a more general nature are noticeable in the studied cases. In contemporary discussions criminals were often described as a problematic type of psychiatric patients, characterized by traits making them unsuitable for care in regular asylums. The investigation shows that insane offenders were subject to different kinds of special treatment, regarding e.g. their release from asylum care, attempts to religious and moral reform, and through considerations surrounding security and discipline. However, despite the frequent portrayal of criminal patients as troublesome, most of them remained in regular psychiatric institutions, and there is ample evidence that individual criminals could enjoy the same liberties and privileges as other patients.
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| 9. |
- Garpenhag, Lars, et al.
(författare)
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Participation in screening for breast and cervical cancer among women with current or previous drug use : a survey study
- 2023
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Women with current or previous drug use (WCPDU) have an increased risk of poor breast and cervical cancer outcomes. Screening is known to decrease the mortality of these common cancer forms, but screening participation has been sparsely investigated among women with drug dependency. The aim of this study was to assess participation in screening for breast and cervical cancer among WCPDU. Methods: We recruited WCPDU to a survey study, from six opioid substitution treatment (OST) clinics and one needle exchange program (NEP) in Malmö, Sweden, and through the Drug Users Union in Stockholm, Sweden. The survey was constructed according to results from focus group discussions about cancer screening in a sample of women in OST. Survey data were analyzed using descriptive statistics. We analyzed associations between non-compliance to screening and healthcare contact (OST, NEP or none) by logistic regression analysis; unadjusted and adjusted for age, native language, housing situation, educational attainment and main source of income. Results: A total of 298 women (median age 43 years) responded to the survey. The self-reported compliance with cancer screening recommendations was 29% for breast cancer screening and 41% for cervical cancer screening. Non-compliance with cervical cancer screening was associated with NEP participation in univariate but not multivariate analysis. We did not find an association between non-compliance with breast cancer screening and healthcare contact. Non-compliance with screening for cervical cancer was also associated with unstable housing in univariate and multivariate analyses, and inversely associated with increasing age in a univariate analysis. Non-compliance with breast cancer was associated with unstable housing in a univariate analysis, and inversely associated with not having Swedish as a native language in a multivariate analysis. Conclusion: The self-reported compliance with the national cancer screening programs for breast cancer and cervical cancer of WCPDU is notably lower than in the Swedish general population. Women with unstable housing seem to be particularly vulnerable to non-compliance with cancer screening. Interventions to minimize barriers to cancer screening are crucial to decrease the increased cancer morbidity and mortality among WCPDU.
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